British Company Is Awarded Contract to Administer Health Rollout
By ROBERT PEAR
WASHINGTON — Racing to meet an October deadline, Obama administration officials said Thursday that they had awarded a contract worth as much as $1.2 billion to a British company to help them sift applications for health insurance and tax credits under the new health care law.
The company, Serco, has extensive experience as a government contractor with the Defense Department and intelligence agencies, and it also manages air traffic control towers in 11 states and reviews visa applications for the State Department. But it has little experience with the Department of Health and Human Services or the insurance marketplaces, known as exchanges, where individuals and small businesses are supposed to be able to shop for insurance.
Serco will help the Obama administration and states determine who is eligible for insurance subsidies, in the form of tax credits, and who might qualify for Medicaid. Tasks include “intake, routing, review and troubleshooting of applications,” according to the contract.
“This is a huge undertaking,” said Alan Hill, a spokesman for Serco’s American unit, in Reston, Va. “We have some tight deadlines to meet.”
The exchanges are supposed to be in operation in every state by Oct. 1. Under the contract, Mr. Hill said, Serco and its subcontractors will immediately begin hiring 1,500 people.
Since the government first invited proposals, the importance of the exchanges has grown for several reasons. Many states have decided not to expand Medicaid, and the White House announced this week that it would delay, until 2015, a requirement for larger employers to offer coverage to employees. In addition, many states have decided not to set up exchanges, leaving the task to the federal government.
Several insurance and health policy experts said they were surprised at the selection of Serco because it did not have experience with the exchanges. But that may have helped the company win the contract. In the last six months, federal health officials expressed concern that companies already working with exchanges could have an unfair competitive advantage because they had access to nonpublic information about how the government was setting up its eligibility and enrollment system.
-There's now so much money in the healthcare system that we're beginning to export some of it!
-SPC
Conservatives’ Aggressive Ad Campaign Seeks to Cast Doubt on Health Law
By JEREMY W. PETERS
WASHINGTON — Though many of its rules will not take effect for months, President Obama’s health care law is already the subject of an aggressive advertising campaign by Republicans to sow doubts about how it will work.
In one of the largest campaigns of its kind, Americans for Prosperity, a conservative advocacy group financed in part by Charles and David Koch, will begin running television commercials this week asserting that the law will limit Americans’ health care choices.
The group is spending more than $1 million on the campaign, which will initially include television advertising in Ohio and Virginia, along with online ads asking people to test their “Obamacare risk factors.”
Republicans have staked much of their near-term political success on the bet that the health care overhaul will be unpopular with Americans as it is implemented in a process that they have warned will be chaotic and frustrating. Many Republicans in Congress have said they would push to repeal the law.
So far, the persistent criticism of the law has served the party well with its base. Now, Republicans hope it will resonate with swing voters the party needs to recover from its losses last year.
In a significant strategic shift, Americans for Prosperity is carefully aiming its new campaign at one of those voting blocs: young women.
“How do I know my family is going to get the care they need?” asks a young mother of two who stars in a commercial, the first in a series that Americans for Prosperity plans to expand to as many as seven states. “Can I really trust the folks in Washington with my family’s health care?”
The ads will be broadcast on cable and network television during programs popular with women like the Food Network cooking competition “Chopped,” “Law & Order: SVU” and “Good Morning America.” Mr. Obama’s political group, Organizing for Action, started running ads of its own last month that promote the law’s benefits.
A Hidden Consensus on Health Care
By ROSS DOUTHAT
TO follow what’s happening with the new health care law right now, you have to understand that for all the deep divisions on the issue, there’s actually a real bipartisan consensus about how the American health care system ought to be reformed.
Or rather, there are two of them — a dishonest consensus among politicians and an honest consensus among people who study public policy for a living.
The politicians’ consensus is that health care reform shouldn’t alter or disrupt the way the majority of Americans get their insurance today. This is President Obama’s official position on the issue: again and again throughout the fraught 2009 debate, he reassured voters that if they liked their existing health care plan, his bill wouldn’t prevent them from keeping it. It’s also the official position of his Republican critics, who have consistently attacked Obamacare for undercutting that presidential promise — for slashing Medicare, for driving up premiums and for threatening the employer-provided insurance status quo.
The policy consensus, though, is that the status quo is actually the problem, and that it deserves to be threatened, undermined and replaced as expeditiously as possible. Wonks of the left and right disagree on what that replacement should look like. But they’re united in regarding employer-provided coverage as an unsustainable relic: a burden on businesses, a source of perverse incentives for the health care market and an obstacle to more efficient, affordable and universal coverage.
Yet woe betide the politician who dares to publicly agree. That’s what John McCain discovered in 2008, when he proposed a sweeping reform that would have eliminated the tax incentives that undergird employer-provided coverage. Conservative policy types loved the idea (as well they should, being responsible for it), but it cost McCain dearly: the Obama campaign used it to attack him, relentlessly and effectively, as an enemy of the way most middle-class people get health insurance, and thus of the middle class itself.
These attacks, in turn, constrained the Obama White House when it came time to design its own health care reform. Obamacare has an unwieldy, Frankenstein’s monster quality in part because the law is trying to serve both consensuses at once. The core of the bill, the subsidies for the uninsured and the exchanges where they can purchase plans, is designed to offer a center-left alternative to the existing system. But much of the surrounding architecture is designed to prop up existing arrangements — and in the process, protect Obama from exactly the kind of criticisms he once leveled against McCain.
Getting Insurance to Pay for Midwives
By ELISABETH ROSENTHAL
Medical doctors deliver more than 85 percent of American babies, and the overwhelming majority of births in the United States take place in hospital labor and delivery wards. But in many European countries, midwives attend to most pregnancies, often in clinics, resulting in maternity charges that are a fraction of those in the United States.
At a time when the United States is looking for ways to rein in its runaway medical spending, a surprising glitch is preventing American women from choosing the low-cost option: Many insurance plans do not have midwives in their provider networks, or do not cover midwife care at all.
Dozens of readers expressed their frustration on this topic in response to a New York Times article on the high costs of maternity care in the United States,“American Way of Birth, Costliest in the World.” One said that her insurer at first refused to pay for her midwife delivery as an “unauthorized service,” though it later relented after she fought back. Another, in Kansas City, said that her insurer, UnitedHealthcare, had no birth centers in its local network. Another, in New York, relayed that her “comprehensive medical insurance” wouldn’t cover her childbirth at a birthing center at all, and she noted: “If I had used a medical doctor, medications and had a C-section with a hospital stay of one week, my coverage would have been 100 percent.”
Susan Pisano, vice president for communications at America’s Health Insurance Plans, a trade group, said that care for midwife services varied widely among plans, adding: “If this is a feature that is important to you, you have to ask before you enroll.”
Thirty-three states require private insurers to cover nurse-midwife services, according to the American College of Nurse-Midwives. But access to coverage is often further limited in practice by whether midwives can get privileges to treat patients at local hospitals, whether freestanding birthing clinics are permitted and local medical custom, Ms. Pisano said.
“It’s really complicated, because the restrictions on midwife practice are such that they most often end up working for a hospital or an obstetrician,” helping out with prenatal visits and deliveries, said Eugene Declercq, a professor at the Boston University School of Public Health.
In that case, when midwives serve as “physician extenders,” their presence may not be cost-saving but add to the nation’s maternity bills, since their services will be charged as an additional physician visit. And they will follow the practice patterns of the doctor, he said.
One of the reasons midwife care saves money is that midwives generally order fewer tests and their patients are less likely to end up having Caesarean deliveries, studies have shown.
Amid cuts, Maine hospitals still paying high salaries
Critics say medical facilities plead poverty and lay off workers but continue to compensate executives and surgeons with substantial payouts.
By J. Craig Anderson canderson@pressherald.com
Staff Writer
Staff Writer
Ten hospital employees in Maine were paid more than $1 million in 2011, including one former executive who received more than $2 million, according to the latest financial data released by the Internal Revenue Service.
Critics say such high salaries contribute to Maine's economic woes and restrict access to affordable health care, just as the state's hospitals are about to receive an estimated $484 million in state and federal funds.
Six of the executives and physicians who made $1 million or more work for Maine Medical Center in Portland or its parent company, MaineHealth.
Overall, the average salary for Maine's top hospital and health care group executives was slightly higher than the national average, according to a Maine Sunday Telegram analysis of the data, which were released this spring.
While industry representatives say Maine hospitals still pay less than their counterparts throughout the Northeast, some state lawmakers and medical professionals have criticized the level of compensation, saying it contributes to the high cost of health care in Maine.
That criticism comes after Maine Medical Center, which announced a hiring freeze in the spring, began offering voluntary retirement buyouts to 400 employees about two weeks ago, citing a $13.4 million operating loss in the first half of its fiscal year. Other hospitals in Maine have also had financial problems recently: Eastern Maine Medical Center in Bangor announced plans to eliminate 17 positions in its laundry, and Parkview Adventist Medical Center in Brunswick announced it would close its intensive care unit and eliminate 16 positions.
Maine’s highest-paid hospital staff
The following is a list of top-paid hospital executives and medical practitioners in Maine, based on reports filed by each hospital with the Internal Revenue Service. Each hospital submits financial data annually to the IRS using what’s known as a Form 990. The most recently available forms are for fiscal year 2011, which began in September 2010.
All data is from 2011.
Proud to own a business and pay taxes to bolster Maine communities
Posted July 07, 2013, at 8:50 a.m.
Small businesses need economy-boosting investments, not offshore tax dodging.
When President Franklin D. Roosevelt signed Social Security into law in 1935, he said: “This law … represents a cornerstone in a structure which is being built but is by no means complete. … It is, in short, a law that will take care of human needs and at the same time provide the United States an economic structure of vastly greater soundness.”
For generations, Social Security, along with Medicare, has met that promise.
But in current debates in Washington, D.C., over tax and budget priorities, it seems we’ve forgotten this important lesson from history — that the way to build a strong economy and a prosperous nation is through investments that bolster the economic security of everyone in our communities.
For the last 25 years, my husband and I have owned and operated Mid-Maine Restoration. We’re a third-generation, family-run business that specializes in historical restoration of steeples and towers. So I know a thing or two about both preserving history and what fuels local economies.
It’s an honor to go to work every day, whether rebuilding dormer windows at the old Maine General Hospital Building in Portland, manufacturing new clock hands for the First Baptist Church in Bath, or installing a replica tower at the Lincoln County Courthouse in Wiscasset.
Small business owners and our employees work hard, and we’re counting on the promise of Social Security and Medicare for our retirement. For many, these earned benefits may be the sole source of retirement security: According to a recent poll, only one-third of small businesses offer a retirement plan.
So it’s galling that some politicians have proposed cutting these programs in the name of “deficit reduction.”
A report this year from the Main Street Alliance reveals that even a 3 percent cut to Social Security would take $109 million out of Maine’s economy. A similar cut to Medicare would cost us $68 million. That’s the last thing small businesses need in a fragile economy.
Instead, we should be strengthening retirement security, building on Social Security as a structure that, as Roosevelt said, is “by no means complete.”
How do we pay for it? The answer lies in another piece of history that has been lost — a definition of corporate responsibility that includes paying your fair share of taxes.
Even as corporate profits have hit record highs, the corporate share of federal tax receipts has plummeted to near 70-year lows.
In some recent years, profitable multinationals like General Electric, Wells Fargo and Verizon have paid no federal income tax at all — or even gotten tax refunds — by exploiting tax loopholes. A recent Senate investigation spotlighted how Apple has avoided billions in income taxes through a complex web of offshore subsidiaries.
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